Associated Impact
Inflammatory responses interrupt the critical alveolarization phase of
lung development, restricts alveolar numbers/size, impairs lung growth
with consequent reduced vital capacity and proportional reduction in
forced expiratory volume or obstructive lung disease.
Other associated impact is that from maternal smoking and other maternal
factors, nutrition and allergic sensitisation. All these have negative
influences on lung function.
Infants are more likely to have lung infections and independently more
likely to have adult lung disease and/or poorer lung function. Pneumonia
pathogens can damage ciliated bronchiolar epithelium and connective
tissue. Also airway clearance defences is impaired.
The cycle of repeated or persistent infection and inflammation involving
airway infiltration by activated neutrophils and CD4+ T-lymphocytes, can
lead to degradation of bronchial wall supporting structures, bronchial
dilatation and ultimately bronchiectasis.
In indigenous communities and developing countries bronchiectasis is
associated with preterm delivery and episodes of early and recurrent
pneumonia during infancy. Adults with recently diagnosed bronchiectasis
had associated with repeated lower respiratory tract infections during
childhood.
Conclusions
Pneumonia in children causes a considerable worldwide burden of
mortality and morbidity in survivors. Infectious insults in the first
1–3 years of life are independently associated with an increased risk
of impaired lung function in adulthood. This is greatest in those with
severe pneumonia hospitalized for treatment. The long-term effects
associated with early childhood pneumonia include restrictive or
obstructive lung function deficits and increased risk of adult asthma,
non-smoking related COPD, and bronchiectasis.
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